Objective: To report male gonorrhea incidence trends between the years 1974 and 1996 and compare the epidemiologic characteristics of the affected population during periods of high and low incidence of the disease.
Study design: Retrospective study of all available data for male gonorrhea cases recorded annually in a major STD hospital in Greece since 1974.
Results: An abrupt drop in gonorrhea relative incidence occurred in 1986, followed by low rates thereafter. In the context of the overall decline in the incidence of the disease, a shift to older ages, longer time elapsed before seeking medical assistance, and higher proportion of disease repeaters was noticed among the patients. Infections caused by penicillinase-producing gonococci were strongly associated with contacts outside the country or with foreigners and their incidence presented erratic time fluctuations, indicating that they have not been established as endemic in the Greek population.
Conclusion: The core group hypothesis in terms of nighttime sociosexual activity can be used to interpret most of the findings.
PIP: Trends in Neisseria gonorrhoeae incidence rates in men presenting to a major sexually transmitted disease hospital (Andreas Sygros) in Athens, Greece, in 1974-96 were evaluated and gonorrhea risk factors during periods of low and high incidence were compared. An abrupt drop in the relative incidence of gonorrhea occurred in 1986, followed by low rates thereafter. A comparison of the periods 1974-85 (high incidence) and 1986-96 (low incidence) revealed a 1.27-fold decrease in total attendance to the hospital and a 5-fold decrease in the number of gonorrhea cases detected. Observed over time was a shift to older ages, longer time elapsed before seeking medical assistance, and a higher proportion of disease repeaters. Infections caused by penicillinase-producing gonococci were strongly associated with contacts outside the country or with foreigners and their incidence was characterized by erratic time fluctuations, suggesting that they have not become endemic in the Greek population. Changes observed in the features of the affected population indicate a trend toward increased risk in sexual behavior.